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Robotic Surgery Robotic Surgery Status Quo + Development Status Quo + Development
Martin KalošMartin KalošCzech Society for Robotic SurgeryCzech Society for Robotic Surgery
3rd of December 20123rd of December 2012AlmatyAlmaty
Czech Society of Robotic Surgery
da Vinci® Si HD
S M
od
el
Up
date
s
Si M
od
el
Up
date
s
• 3D HD Vision (720p) • Multi-quadrant access• Interactive video displays
• Enhanced HD Vision (1080i)• Dual Console option• Upgradable architecture
• 3D Vision• EndoWrist Instrumentation• Intuitive® Motion
Core
Tech
nolo
gy
1999
2006
2009
Current Development
da Vinci® Si™
Firefly™ Fluorescence Imaging
Skills® Simulator™
Advanced Instrumentation*
Single-Site™
*EndoWrist Stapler is pending 510(k) clearance
Single Site Surgery:
Open Surgery Single Incision LaparoscopyLaparoscopic Surgery
PN
875
26
5 R
ev A
1
1/1
1P
N 8
75
26
5 R
ev A
1
1/1
1
Single-Site™ Instrumentation has CE Mark and is FDA-cleared for cholecystectomy.
da VinciTM Single Site
SCOPE
da VinciTM Single Site
New Instruments
FluorescenceExcitation laser light from illuminator
Return signal from fluorescing ICG
Identify vessels during IMA / IMV dissection
Assess perfusion of large bowel prior to transection
Assess perfusion of rectal stump prior to transection
Fluorescence
ROBOTIC SURGERY IN THE WORLD
• Installations worldwide: 2 341– 389 v Europe– 1 707 USA– 245 Rest of the World
Installments – World Data
2 1322 341
Procedures – World Data
278 000
360 000
Abdominal Surgery Thoracic Surgery
General surgery
Vascular SurgeryGynecology
Lung Surgery
UROLOGY
Cardiosurgery
ENT
ThyreidoctomyTongue Base CA
Indications – World Data
Indications – Czech data
Urology
Most Frequent
1.daVinci Radical Prostatectomy
2.daVinci Partial Nephrectomy
daVinci Prostatectomy Results
Oncological effects of Robotic Surgery
Positive marginsRobotic x Laparo x Open
1. dVH : da Vinci Hysterectomy 2. dVSC : da Vinci Sacrocolpopexis3. dVM : da Vinci Myomektomie
Gynecology
Most Frequent
daVinci Hysterectomy Results
General
Surgery
Most Frequent
1.dV LAR : da Vinci Low Anterior Resection
2.dVTh : da Vinci Thyreoidectomy
robotic Versus Laparoscopic Low Anterior Resection of Rectal Cancer: Short-Term Outcome of a Prospective Comparative Study* from Dr. Baik. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Annals of Surgical Oncology. 2009.
*Baik, et al. robotic Versus Laparoscopic Low Anterior Resection of Rectal Cancer: Short-Term Outcome of a Prospective Comparative Stud. Ann Surg Oncol DOI 10.1245/s10434-009-0435-3.
191.1 ±65.3190.1 ±45.0Operative Time
0.0085.5 ±1.54.7 ±1.1Days to Soft Diet [Mean ±SD]
0.0017.6 ±3.05.7 ±1.1Length of Stay [Mean ±SD]
0.013
0.033
0.025
P
2 (3.5)0 (0.0)- Incomplete [n (%)]
0 (0.0)
4 (7.1)
52 (92.9)
1
5.4%
56
Robotic LAR
Macroscopic Specimen Judgment
57Number of Patients
6 (10.5)Conversion Rate [n (%)]
12 (21.1)- Near Complete [n (%)]
43 (75.4)- Complete [n (%)]
4- Anastomotic leakage (n)
19.3%Complication Rate (%)
Lap LAR
191.1 ±65.3190.1 ±45.0Operative Time
0.0085.5 ±1.54.7 ±1.1Days to Soft Diet [Mean ±SD]
0.0017.6 ±3.05.7 ±1.1Length of Stay [Mean ±SD]
0.013
0.033
0.025
P
2 (3.5)0 (0.0)- Incomplete [n (%)]
0 (0.0)
4 (7.1)
52 (92.9)
1
5.4%
56
Robotic LAR
Macroscopic Specimen Judgment
57Number of Patients
6 (10.5)Conversion Rate [n (%)]
12 (21.1)- Near Complete [n (%)]
43 (75.4)- Complete [n (%)]
4- Anastomotic leakage (n)
19.3%Complication Rate (%)
Lap LAR
Da Vinci Low Anterior Resection (Baik)
Other
1.ENT – Transoral
2.Cardiac
3.Lung
Thank you !